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For claims filed under Part B for cancers that may have been caused by occupational radiation exposure, DOL sends the claim to the National Institute for Occupational Safety and Health (NIOSH) Division of Compensation Analysis and Support [4] for a radiation dose reconstruction. NIOSH requests the energy employee's individual exposure records ...
The Oncology Care Model (OCM) is an episode-based payment system developed by the Center for Medicare and Medicaid Innovation. [1] The multipayer model is designed for discrete instances of care, especially those involving chemotherapy , which triggers the six-month episode.
HCFA was renamed the Centers for Medicare and Medicaid Services on July 1, 2001. [9] [11] In 2013, a report by the inspector general found that CMS had paid $23 million in benefits to deceased beneficiaries in 2011. [12] In April 2014, CMS released raw claims data from 2012 that gave a look into what types of doctors billed Medicare the most. [13]
The International Journal of Radiation*Oncology*Biology*Physics (Int J Radiat Oncol Biol Phys), also known as the Red Journal, is published 15 times each year. [3] In 2011, ASTRO began publishing Practical Radiation Oncology. Also called P.R.O., it is a journal whose mission is to improve the quality of radiation oncology practice.
Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [4] The payor returns the claim back to the medical biller and the biller evaluates how much of the bill the patient owes, after insurance is taken out.
The International Classification of Diseases for Oncology (ICD-O) is a domain-specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. This classification is widely used by cancer registries. It is currently in its third revision (ICD-O-3).